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SENIOR DOC INDIANA PC
NPI 1710748397
Family Medicine in Santa Ana, CA

Active since January 19, 2024
5 HUTTON CENTRE DR STE 950, SANTA ANA, CA 92707(855) 434-7763(949) 281-5550 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 11, 2025, Dec 9, 2024 (2 updates tracked since 2024).

About Senior Doc Indiana Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SENIOR DOC INDIANA PC (NPI 1710748397) is a healthcare organization registered as a family medicine in Santa Ana, California and active in the NPI registry since January 2024. The organization lists Angelica Leyla Soto, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1710748397
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSENIOR DOC INDIANA PC
Location Address5 HUTTON CENTRE DR STE 950Santa Ana, CA 92707-8714
Mailing Address5 Hutton Centre Dr Ste 950Santa Ana, CA 92707-8744 · (855) 434-7763 · Fax (949) 281-5550
Phone(855) 434-7763
Fax(949) 281-5550
Organization SubpartNo
Authorized OfficialAngelica Leyla SotoCredentialing Specialist · (714) 702-5145
Enumeration DateJanuary 19, 2024
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2025
✔ NPI 1710748397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Senior Doc Indiana Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Senior Doc Indiana PC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (4)

Meredith Bock, MD
Neurology
NPI 1447612940
505 PARNASSUS AVE
San Francisco, CA 94143
(818) 648-6941
✔ PECOS✔ Accepts Medicare
John Broderick, M.D.
Emergency Medicine
NPI 1588666424
7755 CENTER AVE STE 630
Huntington Beach, CA 92647
(657) 400-5180
✔ PECOS
Cassie Dundon
Nurse Practitioner
NPI 1831685395
4525 N 133RD ST
Brookfield, WI 53005
(414) 828-8866
✔ PECOS
Jeffrey Thomas
Internal Medicine
NPI 1932337136
2592 N SANTIAGO BLVD
Orange, CA 92867
(855) 434-7763
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Senior Doc Indiana PC's NPI number?

The NPI number for Senior Doc Indiana PC is 1710748397. It was assigned to this organization in the NPPES registry on January 19, 2024.

Where is Senior Doc Indiana PC located?

Senior Doc Indiana PC is located at 5 Hutton Centre Dr Ste 950, Santa Ana, CA 92707. The listed phone number is (855) 434-7763.

What is Senior Doc Indiana PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Senior Doc Indiana PC enrolled in Medicare?

Yes. Senior Doc Indiana PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Senior Doc Indiana PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Senior Doc Indiana PC, in Emergency Medicine, Internal Medicine, Neurology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Senior Doc Indiana PC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.